Pennie rates rise across the board for 2027, despite being lower than insurers’ initial proposals

Pennsylvanians who purchase their insurance through Pennie, the state's Affordable Care Act (ACA) Marketplace can expect higher costs for 2027, although the final rates are lower than what insurers were seeking.

Insurers initially proposed a 17.14% increase for those who purchase their own insurance and 11.49% for small businesses. The Insurance Department negotiated those increases down to 15.97% for individuals and 10.28% for small businesses for 2027.

The Pennsylvania Insurance Department denied nearly $95 million in what it called unjustified insurance premium increases for insurers.

Michael Humphreys, the state’s insurance commissioner, said that means real savings for Pennsylvanians insured through Pennie despite overall cost increases.

“When we push the rate down from the 17 proposed down into the 15s [percentage increase], what that means in real dollars for Pennsylvanians is about $95 million in premiums that they won't have to pay next year because we pushed those rates down from where they were otherwise proposed to be,” Humphreys said.

Bringing the rates down for 2027

The Insurance Department’s actuarial team reviews the insurers’ submissions, which typically get filed in the spring. The team looks for places to push back on the insurers where they are unnecessarily justifying higher costs.

Humphreys said this year the Insurance Department was able to find some savings in margins, morbidity assumptions and potential fraudulent enrollments.

Pennsylvania Insurance Department

But health care costs rose overall, due to factors like federal policy and prescription drug usage.

“The driving factors that we continue to see are the cost of the claims continuing to go up. We saw year-over-year medical claims [go] up by 13%,” Humphreys said. “Drug cost claims went up by 15% from (20)24 to (20)25. It's companies seeking to keep pace with the spending that's going out the door in claims and recouping that on the premium side to make sure they have enough coming in to pay those claims.”

He also pointed to HR-1, also commonly known as the One Big Beautiful Bill Act, for its changes to Medicaid, including work requirements and more frequent eligibility checks, that the Insurance Department believes will cause an increase in the state’s uninsured population.

“The concern is that HR-1 will push individuals off of coverage, whether that be Medicaid or commercial insurance. What that ultimately means is higher costs,” Humphreys said.

“When uncompensated care increases, the hospitals are going to need to look for other ways to bring in revenue sources, and in many cases, that will land on commercial populations in terms of negotiations for provider rates with insurance companies and the commercial market being one area where the hospitals are looking for additional rate from,” he continued.

Pennsylvania’s ACA enrollment by congressional district 

Pennsylvanians already saw price increases for their Pennie plans in 2026.

Federal ACA subsidies expired on Jan. 1, 2026, and were the driving force behind last year’s record-breaking government shutdown.

Pennie found that as of Oct. 6, 214,000 Pennsylvanians canceled their Pennie plans since open enrollment for 2026. On average, Pennie found premium prices increased by 102% since the subsidies expired.

A three-year extension on the subsidies passed the House in January, but the legislation has since stalled in the Senate. 

U.S. Reps. Ryan Mackenzie and Rob Bresnahan, both Republicans who represent Pennsylvania’s 7th and 8th congressional districts respectively, broke with party leadership to advance that legislation. Both voted in favor of the One Big Beautiful Bill.

“Families in NEPA cannot afford to have the rug pulled out from under them. Doing nothing was not an option, and although this is not a bill I ever intended to support, it is the only option remaining,” Bresnahan said in a social media post last December.

“I urge my colleagues to set politics aside, put people first, and come together around a bipartisan deal,” he continued.

“I am committed to helping working families, seniors, and everybody who wants to see lower costs,” said Mackenzie in a statement last December. “Many in our community, especially small-business owners and the self-employed, are concerned about the cost of healthcare for the coming year. This is a serious issue with real-world consequences — we must find commonsense, bipartisan solutions to protect access to health insurance for families in the Lehigh Valley and the Poconos."

Nonprofit health policy research, polling, and news organization KFF recently published a map that tracks ACA enrollment by congressional district. KFF found that 3.6% of Pennsylvanians are enrolled in the program.

KFF found the state’s 7th Congressional District, represented by Mackenzie, has 27,000 ACA enrollees, which is about 3% of the district's total population. The 8th District, represented by Bresnahan, is home to 28,000 enrollees, about 4% of the district's total population. And the 9th Congressional District, represented by Republican Rep. Dan Meuser, has 25,000 enrolled in the ACA, about 3% of the population.

Pennie

Be prepared to shop around

Humphreys knows even though increases came down from insurers’ initial proposals, costs will still be much higher for many Pennsylvanians. He encourages Pennsylvanians to take their time during this year’s open enrollment.

“The message to all Pennsylvanians is to come into Pennie to take a look at what options are available out there. Every year, the subsidy amount or the financial assistance via the tax credit could change. The affordability situation could change for you,” he said.

“Go in and take a look at what options are available to you. Maybe that's moving from a gold plan to a silver plan, or considering some of the other plan options that may be available. But hopefully, you can find one that has a premium that, yes, it's increasing, but maybe is more palatable than the rate increase for your particular plan right now,” Humphreys continued.

He wants Pennsylvanians to remember the protections provided by the ACA, such as coverage for pre-existing conditions, preventive care, prescription care, hospital visits, limits on out-of-pocket costs each year and more.

“We would encourage you to talk to an insurance agent about what other options may be available if you don't qualify for assistance through Pennie. Maybe they can look at a shorter term plan. But the hard part when you start moving off of Pennie, you lose the guarantees,” he said.

Humphreys said the Pennie board found that of the more than 700,000 uninsured Pennsylvanians, there are about 350,000 of them that could potentially be eligible for financial assistance through Pennie.

“Pennie is going to continue to aggressively advertise and get the word out about financial assistance and competitive coverage available through Pennie, and you will continue to see [the Insurance Department] encourage individuals to go out and look for plans and to contact Pennie to talk about what health insurance options are available,” he said.

Open enrollment, the period when people can shop for and change their plans on the ACA marketplace for 2027, starts Nov. 1 and ends Jan. 15, but the deadline for plans starting on Jan. 1 is Dec. 15.